Care and Feeding of the Musculoskeletal System

Getting To Know You

Why do we care about the musculoskeletal system? In a word, it's pain. When anything goes wrong with the workings of our muscles, bones, joints and the connecting tissue, pain is the first indication. It can be excruciating and debilitating and the first thing we reach for is the pain pills.

Here's the problem with that...some of them are dangerous when used for any length of time and we need to know what is dangerous and what is safe.

Knowledge is power so the first logical step is to get acquainted with this vital system and understand how it works. We'll start by flexing our muscles.

But first, if you don't want to read through the musculoskeletal system material and just want to know how to keep it working, you can skip down to the last section of this page and find it there. You will also see a Google Search Box at the bottom of the page to help you navigate around the "Healthy by Nature" site.

OK back to basics. Besides giving movement to the musculoskeletal system, muscles provide stability, help regulate organ systems and generate heat when we need it.

Most of us are 50% muscle by weight which is explained by the fact that, for equal volumes, muscle weighs more than fat.

What happens when we get cold? Most of us start to shiver. It's not something we control, it just happens, and it's muscles that create those shivers. It's the movement, the shivering, that generates the heat. We lose heat through our surface area of our skin. Area is a square measurement as in square inches.

Since muscle is mass and mass implies a volume as in cubic inches, we generate heat according to cubic volume. So up to a point, we can generate heat faster than we lose it but it doesn't go on forever. Muscles try to keep us alive until we can get to a warmer locale and stop the heat loss. It's a very important survival mechanism since our heart stops when our body temperature drops to 93 degrees Fahrenheit.

Just as a matter of interest, at the other end, if our body temperature rises to around 108 degrees, the proteins in our brain start to become denatured, that is, they start to unfold. Next thing you know, we are a comatose turnip on life support.

How about movement? When it comes to the musculoskeletal system, muscles travel a one-way street. The musculoskeletal system only lets muscles contract. So that means most muscles come in opposing pairs. When you want to curl you arm up, the bicep contracts and bends the arm up at the elbow.

If you want to lower your arm, then the opposing tricep contracts, pulling the arm back down. Ever wonder exactly what it is that makes a muscle contract?

It's electricity. Muscles are conductors of electricity so when our brain sends an electrical pulse to a specific muscle, it responds by contracting.

How about types of muscle inthe musculoskeletal system?

Not all muscles are the same and the differences are wrapped up in their function. The three flavors, or types, are skeletal, smooth and cardiac muscles.

Skeletal muscle

As we saw earlier, muscles are excited by nerves carrying an electrical impulse that causes the muscle to contract. Skeletal muscles are mostly voluntary, meaning they work because we will them to work. We have conscious control over them.

Looking at their construction, we see that they are striated or striped; they have molecular structures called myofibrils; thin filaments called actin and thick filaments called myosin. Furthermore, they have little spurs that ratchet up on each other much like gears on a cog.

Photo above: Microscopic view of skeletal muscle tissue

Although muscles can help us lift quite heavy weights and move our bodies from here to there, muscle tissue is very fragile and can be easily torn and separated.

Surgeons learned early on that they can't stitch muscle tissue. The stitch won't hold and will usually cut right through the muscle tissue. Who would have thought?

Smooth muscle

Smooth muscle appears in more irregular bundles and, like all muscles are awakened and kicked into action by an electrical impulse. Smooth muscles can be activated by a single nerve or multi-unit distribution of nerves. They form in interwoven clusters.

Photo right: Image of smooth muscle tissue

What sets smooth muscle apart is that they are not voluntary; they just keep on working (hopefully) whether we want them to or not. Typically, we aren't even aware of them until they decide not to go on working. Functionally they regulate the size and shape of our internal organs and assist glands to do their job.

Cardiac muscle

As the name implies, cardiac muscle is what keeps our hearts pumping away day and night. They are also striated and exhibit a more coordinated contraction. Like smooth muscle, they are involuntary but highly rhythmic in action. Cardiac muscle, in fact, functions as our pacemaker and is stimulated by motor neurons.

Photo below: Image of cardiac muscle tissue

These muscles are so finely tuned that the brain can actually choose exactly which muscle fibers it wants to activate. As we might imagine, there is a huge blood supply to cardiac muscle and any disruption to that supply will cause a heart attack in very short order.

In addition, nature wanted our hearts to beat with a very definite beginning and end and it set up an extremely complex chemical signaling system in the synapses of the nerves that start and stop the cardiac muscle activity.

The very simple explanation is that the motor neuron has a bulb at the end of its synapse that touches the muscle fiber. There is a tiny vesicle in the neuron that holds the chemical Acetylcholine (Ach).

It so happens that musculoskeletal system muscle fibers have receptors for acetylcholine and when Ach hits a target receptor, it fires, after which a channel for sodium opens up and then releases another chemical called acetylcholinesterase which instantly stops the entire process.

Then there follows a short rest period called a refractory process during which the muscle repolarizes, pumps the sodium out and sets itself up to refire and the beat goes on

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How the Musculoskeletal System Muscles Move

Let's look at how muscles interact with bone to produce both stability and movement in the musculoskeletal system.

The musculoskeletal system has nearly 700 skeletal muscles that act as levers to produce opposing forces and use mechanical advantage in different ways. Nevertheless, all muscles use lever principles to work. Take a quick look at the diagrams to see how first, second and third class levers work, then we will relate them to muscles.

Photo below left - First class lever; below right - Second class lever

Muscles in back of neck that keep the head up are 1st class levers with a nearly 1:1 ratio. Note that the fulcrum (the triange) is in middle which would be the neck. Neck muscles are the downward pointing force and the head (up arrow) is the resistance.

The calf muscle is a 2nd class lever where the fulcrum is at end (front) of foot with effort supplied by the calf muscle.

Photo below left: Third class lever as seen in the elbow and forearm

Most musculoskeletal system muscles are 3rd class levers such as the elbow and forearm. The fulcrum is at the elbow, resistance in the hand and force of effort in the bicep muscle. The thigh muscles operate the same way.

Before going on, we need to clarify some terminology of the musculoskeletal system.

Photo below: Anterior view of muscle groups

"Top" is referred to as proximal and "bottom", or away, is distal. Thus the bicep brachii muscle attaches to the top, or proximal end, of the shoulder and the bottom, or distal, attaches to the radius in the forearm. The top attachment is the "origin"; the bottom attachment is the "insertion".

Tendons are at the end of each muscle group and made up of collagen and attach muscle to bone. They are thickened and make up for the fragility of the muscle. While muscles can exhibit great strength, they are quite fragile.

Ligaments, on the other hand, attach bone to bone and provide stability to joints.

Almost all of the muscles can be grouped according to descriptions of their characteristics. For example, the following five muscle adjectives all refer to size.

Maximus is the largest in the group, such as gluteus maximus, largest of the gluteal muscles

Minimus means the smallest; whoever heard of the gluteus minimus, the smallest of the gluteal muscles?

Longus is the longest as in adductor longus in the thigh group

Brevis is the shortest as in adductor brevis, a short muscle in the thigh group

Latissimus means the widest, as in latissimus dorsi, the wide flat muscle on the trunk behind the arm

Photo right: Posterior view of muscle groups

Other muscles are named according to shape descriptors.

Trapezius means trapezoid and is a trapezoidal shaped muscle in the upper back

Deltoids are the delta shaped shoulder muscles

Serratus are saw-toothed muscles; the serratus anterior muscle is at the upper nine ribs

Platysma means flat and is a large sheet of a muscle along the neck

A few are named according to their direction of force. The Rectus Abdominis runs along the length of the body on either side of the front wall of the abdomen. It is the muscle responsible for the six-pack abs.

Oblique muscles run to the diagonal and transverse are situated perpendicular to axis of the body.

Numerous muscles are named for their movement. A few quick examples are:

We'll wrap this up with three very specific functionally named muscles. The Risorious muscle makes us smile, the Masseter is for chewing and the Sartorius goes from our hip to our knee and lets us pull one leg up and out so we can cross our legs.

Keeping Muscles Healthy

It should be intuitive that if we have good strong healthy muscles, we will have a better shot at having a more fit healthy body. Why should that be true?

Consider that muscle at rest burns more calories per minute than fat. Sounds like a no-brainer since fat doesn't burn calories anyway, it stores calories and only gives them up if called upon. So if we have more muscle tissue we naturally burn more calories, even if we're just lying there doing nothing.

The common belief is that as we get into later decades of life, we get on a downward spiral of decline. Actually this can now be classified as a myth and the myth has been busted.

Trials were conducted in which elderly people in nursing homes were put on training programs that involved pumping iron and other strength building routines. They started showing new muscle growth with more strength and mass being generated. They had younger musculoskeletal systems.

The end result was that they were able to get rid of walkers and canes; they stopped falling down and were able to be weaned off many of their prescription meds. What's the message? Strength training builds muscle and restores general health!

Why? Because having a healthy muscle mass promotes more efficient use of oxygen which in turn tends to help us burn more fat as fuel instead of carbs and protein. So it follows that artery and heart function should improve and cognitive abilities should improve due to more blood flow to the brain with it load of nutrients and oxygen.

Types of Muscle Exercise

Isotonic and isometric contraction

Isotonic contraction of muscle means that the tension remains the same as the muscles length changes; "iso" means same, "tonic" means tension. An example of isotonic muscle contraction is where we sit on a bench with a dumbbell in our hand and do slow curls.

Isometric contraction means that the length of muscle stays the same; in other words, there is tension on the muscle but no movement occurs. A typical isometric exercise is where we try to lift one hand while using the other hand to keep it down.

Which will build more muscle? Isometric will build a lot of strength (muscle) but won’t build bone (more on bone to come). Concentric and eccentric exercises is movement of positive and negative repetitions, that is, slow movements with the same weight (isotonic contractions).

Eccentric contraction (the downward movement) is more damaging to muscle. But weightlifters want to damage muscle to some extent so the body will then come in and repair the muscle. The result is an increase or build up in muscle tissues.

Aerobic Exercises

Aerobic exercise uses oxygen rich blood by doing conversational jogs, meaning jogging at a pace such that it is comfortable speaking to your jogging partner. On the other hand, anerobic exercise is weight lifting, sprinting, stop and go and is more damaging to the joints. Nevertheless, a combination of both is recommended depending on ones age.

Interval Training

Interval training combines aerobic and anaerobic at the same time. Interval training is a type of physical training that involves bursts of high intensity work alternating with periods of rest or low activity, thus the intervals.

The term can refer to any cardiovascular workout (e.g. cycling, running, rowing, etc.) that involves brief bouts at near-maximum exertion interspersed with periods of lower-intensity activity.

Interval training is often practiced by long distance runners (800 meters and above). Sprinters and football players typically use this type of training.

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Bones Give Stature toThe Musculoskeletal System

Bones are a lot more than just a skeleton or the framework and scaffolding of our body.

There are 206 named bones in the musculoskeletal system and what they do is vital to sustaining life.

Yes, they are supporting structure but also they are storehouses for calcium, magnesium and other nutrients and the bright yellow lipid fat in the long bones; factories to produce red blood cells and armor for the protection of our vital organs, especially the brain, lungs and spinal cord.

Because of our musculoskeletal system there is very little exposure of our internal organs to the outside world. Finally they are the levers that move our body which is discussed in greater detail later.

It is also important to note that bone is living tissue, a living organ to be more specific. Bone can replenish itself and regenerate itself and build new bone to replace old or damaged bone.

The new bone will be just as strong as the bone it replaced.

We know from the page on cell physiology that various types of cells replace themselves at varying rates.

The downside of bone cells is that they take a long time to replenish themselves, from four to six months and sometimes up to a year.

Photo: Anterior view of skeletal system

As we will see in coming paragraphs, bone also has a unique structure. They are not solid as many believe, rather they are more like a honeycomb or a sponge. But they aren't the hardest substance in the body, enamel takes first place in hardness.

Introduction to Bone Terminologyin the Musculoskeletal System

The bones of our musculoskeletal system are incredibly complex and diverse. Just consider the range of bone types that a student has to master.

Photo right: Posterior view of musculoskeletal system

There are flat bones as seen in the ilium, the largest and uppermost bone of the pelvis. There are the long bones of the arms and legs such as the humerus of the upper arm or the femur (thigh bone). They have to be both compact and spongy for lightness and strength.

We have short bones that are compact on the surface and spongy inside. Look at the wrist and ankle bones as an example. These little bones can all move by themselves.

In addition, there are many specific function bones. Bones of the vertebrae are specifically designed to protect and cushion the spinal cord. Facial bones are shaped to allow chewing or provide protection for the eyes.

Sesamoid bones are those that are embedded in tendons and have no ligaments attached. The knee cap, or patella, is the best known sesamoid bone. Tendons attach muscles to bone and ligaments attach bone to bone so as not to have bone rubbing on bone; more on this later when we get to joint construction.

Tuberosity describes the roughened, rounded knob where ligaments attach and the tubercle is a smaller knob.

There are many new terms to learn about the gross anatomy of bones and cartilage. For example the humerus (funny bone) has articular cartilage. Cartilage is dynamic living tissue which allows frictionless movement in joints and articular cartilage is one of three types of cartilage we will get to.

The diaphysis is the long part of bone and is almost always hollow and doesn’t grow anymore once it is laid down. Bones need to be fed and this is where nutrient arteries come into the picture. Metaphysis is used to describe where new growth occurs at either end of the bone. Proximal epiphysis is end of the bone that supports the articular cartilage.

The periostem is the smooth fibrous layer on outside of bone. It adheres to bone and can't be peeled off. If we break a bone, the pain comes from breaking the nerves in the periostem, not in the bone itself.

Photo left: Structure of long bone

Marrow is the cavity inside bone and is where red bone marrow is produced. As mentioned earlier, nutrition to bones is provided by arteries and is usually uniform and consistent.

Photo below: Internal structure of spongy bone

Musculoskeletal bone vocabulary seems to be endless. A few more examples to illustrate the point might include the spine of the spinous process; the long blade that extends from the back of the spine.

A trocanter is a hip bone; a condyle is a large knob or rounded surface; an epicondyle is a smaller prominence above a condyle; a facet is a flattened surface of a joint attachment such as seen in the spine; a crest is a ridge on top of a particular bone, for example, the crest of the illium (remember illium...the flat bone at the top of the pelvis?).

A Sinus is any hollow space; a meatus is an opening or canal that a nerve might pass through; a fossa is a depression; a foramen is a hole or opening; and fissures are clefts or slits usually to provide a passage way for something.

Still want to be a musculoskeletal specialist?

How Bones Grow

The Bones of the musculoskeletal system begin as pure cartilage as the embryo forms in the womb. As the fetal development progresses, a calcified matrix starts spreading up and down the bone. After the nutrient arteries form, a secondary ossification center is formed and finally a real bone is built.

Referring to the image of internal bone structure, it will be helpful to identify some more terminology.

The Epiphyseal plate is the border between the metaphysic and epiphyseal. It pushes up and makes the diaphysis longer by being stimulated by growth hormones.

Microscopic Bone Anatomy

Starting at the cellular level, osteoprogenitor cells are the stem cells of the bones in the musculoskeletal system. Some of these osteoprogenitor cells become osteoblasts, cells that lay down new bone tissue. Osteoblasts produce a substance called osteoid, which is composed mainly of a matrix formation of collagen.

Collagen is the strong connective tissue of the musculoskeletal system, millimeter per millimeter, even stronger than steel. Osteoblasts are also responsible for mineralization of the osteoid matrix.

When osteoblasts become trapped in the matrix they secrete, they become osteocytes, star-shaped cells inside dense bone. Osteocytes are networked to each other via long cytoplasmic extensions that occupy tiny canals called canaliculi, which are used for exchange of nutrients and waste products.

One thing to be aware of is that they can be stimulated by certain types of cancer resulting in bone destruction.

From the foregoing, it should be clear that bone is a dynamic tissue, constantly being reshaped by osteoblasts (building bone) and osteoclasts (reabsorbing bone). One reason our bones become thinner as we age is that Osteoblast cells tend to decrease in our later years, thus decreasing the natural renovation of the bone tissue.

The bone structure image above showed a cross section of bone from the outer periosteum fibrous layer inward. Shown are the arteries and spongy bone, and many triangles, much like those used in bridge construction for strength and stability.

Inside the bone are also seen (small spaces or pits) occupied by osteocytes with their associated canaliculi for communication with other cells.

Joints: The Arm Bone's Connected to the Shoulder Bone...Joints are the Connections of the Musculoskeletal System

Essentially, joints connect one bone to another such that motion can occur at the point of connection. Most of them work like a hinge on a door allowing movement in one direction. Others allow bi-directional movement or even circular motion.

Joints are made up of ligaments and cartilage. Recall that ligaments connect bone to bone whereas tendons connect muscles to bone. Cartilage is a dense connective tissue that lines the bones in joints thus helping them move smoothly as well as providing a degree of cushioning in the joint.

To illustrate the various types, construction and action of musculoskeletal system joints, we can look at the three that give us the most problems; our shoulder, hip and knee. Shoulder reconstruction and hip and knee replacements have paid for a lot of doctors Corvettes and ski resorts in Vail.

The Musculoskeletal System Shoulder Joint

The shoulder joint gives us a wide range of circular motion, thanks to the clavicle (collar bone), scapula (shoulder blade) and humerus (upper arm), the three bones of the shoulder.

The top of the humerus fits into a cavity at the neck of the scapula and all three bones are connected by ligaments and the four muscles of the shoulder are connected to the bones by tendons.

The most common aches and pains in the shoulder are caused by a rotator cuff injury. The muscles and tendons that hold the humerus securely in its socket are collectively called the rotator cuff so a rotator cuff injury is usually a strain or tear of a muscle or tendon around the joint.

Most minor injuries will resolve naturally with rest, ice and physical therapy. For more serious tears, the fix usually involves arthroscopic surgery.

Other common shoulder joint problems are bursitis, tendonitis and arthritis; all of which are inflammation issues but we knew that from the "itis" suffix.

The Musculoskeletal System Hip Joint

The hip is the classic ball and socket joint and this particular joint is built more for stability than mobility; after all, it has to support our whole weight when walking or standing.

The main parts of the hip joint are the femur (long thigh bone) and pelvis, the actual joint where the rounded upper knob of the femur fits into a convex, horseshoe shaped receptacle called the acetabulum, cartilage that provides lubrication for frictionless movement, ligaments and a host of muscles and tendons facilitate rotational and forward movement.

The main thing that goes wrong in the hip joint is age related thinning of the joint cartilage. The result is bone grinding against bone causing pain and inflammation.

The diagnosis will be osteoarthritis and it affects over 20 million Americans. It can hit any joint in the body but is most prevalent and troublesome in the hips and knees. Calcium, vitamins C and D and losing weight can greatly help forestall osteoarthritis.

The Musculoskeletal System Knee Joint

The knee joint is like a door hinge, it moves in one plane of motion; backward only, not forward and not side to side. Because of its limited range of motion and the fact that it carries our entire weight, it is very susceptible to strain and injury.

The knee joint is the most complex of all human joints. It sits between the tibia (shin bone) and femur (knee to hip), the two longest bones in the body, which are separated from each other by a layer of cartilage. Without the cartilage, there would be no lubrication or cushioning.

The meniscus is a structure of dense cartilage between the two long bones that forms a cup-like fixture to keep the ends of the bones in place. The effect is to increase the surface area of the cartilage and provide greater lubrication for the joint; incredibly important to the musculoskeletal system.

Regarding lubrication, it is also a synovial joint, meaning that the joint is bathed in a thick, stringy fluid similar in consistency to egg whites.

A synovial membrane secretes fluid into the joint cavity to provide lubrication, shock absorption, oxygen and nutrients and remove waste. It is a very important substance to the health of our knees and musculoskeletal system.

The patella, or kneecap, is worth special mention. It is a thick, triangular bone that moves with the femur and covers and protects the knee joint. It's the largest sesamoid bone in the human body. Remember "sesamoid"? This is a bone completely embedded in a tendon and not attached to another bone.

Other than physical trauma, as with the hip, osteoarthritis is the most prevalent condition to affect the musculoskeletal system and is a condition of aging.

For those of who reach the age of 85, 85% will show osteoarthritis on an MRI but only 50% will have symptoms. It is possible to slow the progression and even reverse its effects by following some common sense antiaging lifestyle adjustment discussed in the last paragraphs of this section.

Keeping the Musculoskeletal System Healthy...Naturally

We need a perfectly working musculoskeletal system to execute any movement, lift any weight and do it all pain free; now that's the challenge.

How do we keep the bones of our musculoskeletal system healthy without Fosamax, Boniva, Evista, Actonel, estrogen replacement therapy or any one of a hundred medications for bone problems?

How do we keep joints flexible without corticosteroids or non-steroidal anti-inflammatory drugs? How do we keep our muscles intact and strong without a little help from the world of pharmacology?

Aside from the muculoskeletal system, she has an interesting story to tell. Take a look.

Exercise

All good questions and the first answer on the list is exercise...sensible, measured, ongoing exercise. Physical stress is good for bones as well as the whole muscloskeletal system. They strengthen themselves in response to being pushed. what bones like is strength training, not stamina training. We need to understand the difference.

Stamina training, like jogging and stair climbing, is good for cardiovascular health but greatly promotes wear and tear on our bones and joints. Bones need resistance training and it doesn't take much. Thirty minutes of weight-bearing exercises a week, broken up into three ten-minute sessions, is all it takes to build and maintain bone density.

Same with muscles. Muscles need to be worked regularly. Use them or lose them and once we lose them, we can look forward to getting around with walkers, canes, wheel chairs and scooters. It just feels good to be fit and has incredible rewards for quality of life.

The one thing to remember about exercise, especially as we age, it to avoid pounding wear and tear on the joints. For example, instead of running, try a recumbent exercise bicycle; it's a lot easier on the knees.

Stretching

Yoga is an ancient form of exercise that can bestow major health benefits to everyone. Too many people, especially guys, seem to have a preconceived notion that yoga is only for new-age wacko's, mystics and the ladies. Wrong on all counts! Yoga is medicine for the musculoskeletal system.

A regular series of yoga exercises will increase lifespan, increase strength, increase flexibility and teach proper breathing and posture. One's daily routine of stamina and resistance training should be followed by at least five minutes of yoga or yoga type stretching.

There are hundreds of yoga poses and movements to work every part of the musculoskeletal system and there are also numerous books and websites devoted to teaching yoga. There are over 13,000 yoga related titles on Amazon.com so browse your heart out.

A couple of reasonably priced, highly recommended books are shown above. Just click on the book covers to take a look at these recommendations and buy if the spirit moves you.

Food and Nutrition

Even a cursory look at the pages of this website will show that good eating habits and supplementation are the foundation of health and wellness of the musculoskeletal system and every other system as well.

Our bodies will heal themselves and perform as advertised if we give then the right tools (nutrition) to do the job.

The following is a short description of the basic nutrients for good musculoskeletal system health.

Calcium is critical for bone health. This is the mineral that strengthens and solidifies our bones and bones are where the body stores calcium until it is needed for other functions.

We can get a lot of calcium from green, leafy vegetables and dairy products but most of us don't eat enough of these foods to even get close to the required daily amounts. To make matters worse, sodas, coffee and sweating remove calcium from our body.

Other cautions are that an excessive amount of protein (over 16 ounces of beef, pork or chicken a day) can cause the body to excrete calcium just as the caffeinated and carbonated drinks do. Add 20 mg/day of calcium for every 12 ounce carbonated soda or 4 ounce cup of coffee and every 4 ounces of protein consumed.

The best insurance is to supplement and men should take 1000 to 1200 mg of calcium a day and women under 60 should take 1200 mg/day and women over 60, 1600 mg/day.

With calcium, absorption is an issue so the amounts should be taken in 600 mg increments twice a day. If the supplement is combined with citrate or carbonate, be sure to check the labels for actual amounts of calcium.

Three more cautions...don't take calcium with antacids since absorption depends on an acidic environment; don't take calcium with an iron supplement since iron retards absorption (take them a few hours apart); and be sure to get enough vitamin D (see below) since calcium absorption depends on vitamin D.

Vitamin D performs a vital function in the musculoskeletal system, namely increasing the absorption of calcium thus making it easier for calcium to get to the bones. Several studies show that people with higher levels of vitamin D had less deterioration in their joints than those with lower levels.

Sources of vitamin D are natural sunlight, food and supplements. Most people don't get enough sun exposure, either due to living too far north or being afraid of getting skin cancer.

Common sense rule...don't get over-exposed to direct sunlight. Also forego the sunblock; it blocks the sunlight-to-vitamin D conversion. Foods rich in vitamin D include fish and shellfish, dairy products, 100 percent natural orange juice and many cereals are now fortified with vitamin D.

Nevertheless, few of us eat enough vitamin D foods to get the minimum required amounts so supplementation is necessary, even mandatory. 400 IU is recommended if under 60 and 600 IU if over 60.

Magnesium supplementation is also recommended for good musculoskeletal health at a level of 400 to 500 mg/day. It helps keep bones strong, in fact 50% of the body's magnesium is found in bone.

Magnesium is needed for more than 300 biochemical reactions in the body but for the musculoskeletal system, in addition to providing bone strength, it helps maintain normal muscle and nerve function. Natural sources of magnesium include almonds, green vegetables such as spinach and unrefined grains.

Omega-3 Essential Fatty Acids is believed to provide the lubrication that the joints need and have been shown to decrease inflammation in affected joints. It can also regenerate the meniscus membrane if it gets torn or exhibits discomfort. The best natural sources are fish, walnuts, flaxseeds, canola oil, olive oil and avocados.

Eating too much fish exposes one to potential heavy metal toxins such as mercury so it is best to go light on the large cold-water fish and supplement with a high quality product that has been cold processed and put through molecular distillation. Look for "Pharmaceutical grade" and "Molecular distillation" on the label.

Vitamin C does many things for the body but for the musculoskeletal system, research is showing that it can help prevent bone loss from osteoporosis and degeneration of cartilage due to aging.

For good bone and joint health, 1200 mg/day is recommended, split between food and supplementation. Don't go overboard on the vitamin C and keep the consumption under 2,500 mg/day. Too much of this good thing can actually increase osteoporosis and may cause DNA abnormalities.

Glucosamine and Chondroitin are a couple of controversial supplements that are believed to provide lubrication for the joints and regenerate cartilage. Glucosamine sulfate is a chemical that surrounds the joints and our bodies need it to make cartilage, ligaments and joint fluid (synovial fluid).

They are only controversial because the media and drug companies like to disparage glucosamine and chondroitin as being ineffective for musculoskeletal system health so they can sell more osteoporosis drugs.

In fact there are randomized, controlled studies that show taking these supplements can keep joints young by repairing damaged cartilage and regenerating cartilage in the knee and hip joints.

Dr. Oz, in his book, "YOU, the Owner’s Manual", recommends 1,500 mg/day of the two combined supplements (preferably in the same pill). He specifically recommends three brands, Triple Flex, Osteo Bi-Flex and Cosamin DS, because they are the only ones that contain adequate quantities of the ingredients in each pill. Click on the book cover above to look it over.

Bromelain is one more that bears mentioning, not because it is a nutrient for musculoskeletal system health, but because it has been shown to have anti-inflammatory properties and can be used to speed recovery from bone and joint diseases. It is found in pineapples and about 100 mg/day is adequate for stiff joints.

Life Style Adjustments

Besides good nutrition and exercise, there are some very basic, common sense things we can do to help our musculoskeletal system. All it takes is some conscious effort and discipline.

The first one is easy. Our mother, our chiropractor and our drill sergeant all told us to stand up straight and suck in that gut. Great advice for strengthening our abdominal muscles and supporting our back.

All we have to do is remember to bring our head and neck back. Next practice breathing in and tightening the gut. Before we know it, back pains will start to disappear and we will absolutely look and feel confident.

The next one is pretty simple too and will help avoid foot problems. Nothing will ruin a day faster than having pain in the feet when walking or standing. Why do so many people come down with foot problems?

Consider that we have 26 bones in our feet, that's 26 bones per foot, for a total of 52 bones that have no shock absorbing fluid or cushioning cartilage that other moveable bones have. They take a pounding and if we happen to be a bit overweight, they take a real pounding.

The answer is simply to wear comfortable, well-cushioned shoes. Running shoes, cushioned in the heel and back of the shoe, are particularly great. Women are especially vulnerable in this area. It's not good to tell a woman she has comfortable looking shoes.

Unless she has her feet stuffed into tight, narrow, spike heels, she's just not "in". It may look sexy and fashionable but they put a constant strain on the calf muscles and Achilles tendon and shift the weight to the frontal bones of the foot. We couldn't create a more perfect setup for future feet problems if we planned it.

What more can be said about smoking and weight? Stop smoking and lose weight! We know very well what smoking does to our lungs, heart and arteries. But in the musculoskeletal system, smoking is destructive to bones and increases the risk for osteoporosis.

Also there is nothing more destructive to the musculoskeletal system joints than carrying around excess weight. Lose the weight or be prepared for future hip and knee replacements, which in the new world, you will probably have to go on a waiting list for two years before you can get your replacement.

So exercise, stretch, eat right, don't smoke, keep your weight in line and your musculoskeletal system will thank you and give you a higher quality of life.

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